Live Well, Live Long

According to the Centers for Disease Control and Prevention (CDC), seven out of 10 Americans will die each year from chronic diseases. Heart disease, cancer and stroke account for more then 50 percent of all deaths each year.

Add diabetes into the mix, said Dr. Patrick Yassini, a Coronado-based physician, and chronic diseases account for more deaths in America than all other causes of death combined.

“What’s shocking to realize is that for the most part all these chronic diseases are preventable,” Yassini lamented. It’s one of the reasons he has now focused his practice on “anti-aging medicine.”

“We all know 90-year-olds who are still playing tennis and 70-year-olds who can’t get out of bed,” Yassini said. “We all want to be that active 90-year-old.

“Like most doctors, I was taught in medical school that if you come into my office and you don’t have a disease, you are well,” said Yassini, a board-certified family practice physician. “But the true definition of being well is much different than being free of diseases. It’s really about being able to get up every morning and do what you want to do, and, at the end of the day, feeling fulfilled.”

In 1992, a nonprofit medical association, the American Academy of Anti-Aging Medicine was founded, with an emphasis on wellness care. Last year, Yassini joined the association of what he terms “forward-thinking physicians in the field of medicine who go beyond Band-Aids, and instead are looking at the mechanisms of diseases.” The academy, composed of more than 22,000 members, including physicians, scientists, researchers, health-care practitioners and government officials from 105 countries, utilizes the phenomenal advances in science and medicine in recent decades in its push for wellness.

“Nationally, there’s been a huge push to improve the way we prevent and screen for diseases, not just treat them,” Yassini said, citing diabetes as one example. “We would like every diabetic to have a cholesterol level below 100, but historically the medical profession has a poor record at meeting the goals of therapy.”

Instead, studies indicate that most diabetic patients are prescribed drugs to lower cholesterol, which doesn’t treat the root problem of lifestyle. Treating and monitoring lifestyle choices — and motivating change of lifestyle — requires a more time-intensive model of care, which doesn’t fit well with today’s managed care methodologies.

“Many of the drugs prescribed routinely in America simply palliate and treat the result of the disease,” Yassini said. “Instead, we should put our efforts into solving the problem.”

Another example is the issue of memory, Yassini said. Rather than automatically dispensing widely advertised drugs for memory loss, Yassini prefers to first optimize a patient’s hormones or micronutrients and monitor the patient for possible improvements. “We’ll do cognitive evaluations in an initial assessment, then after these protocols, retest and often get improvements.”

In a 2006 study, researchers from the Harvard School of Public Health found that the anti-aging lifestyle can add 24.6 more years of productive life-span. The research team found that the longest-living Americans are women of Asian descent residing in Bergen County, N.J., with an average lifespan of 91.1 years.

A distinguishing characteristic of the Bergen County women’s longevity is that they are availing themselves of state-of-the-art biomedical technologies in advanced preventive care, including preventive screenings, early disease detection, aggressive intervention, and optimal nutrition — all of which are cornerstones of the anti-aging medical model.

Fractures can dramatically reduce the quality of your life, “if you survive,” he cautioned, noting that the mortality of hip fractures is high. “If you fall, you are confined to bed, where you are recovering from major surgery and subject to complications, such as pneumonia. A goal of anti-aging medicine is to keep you out of the hospital.”

Fortunately, there are many ways to improve bone density, Yassini said, including weight bearing exercise, Vitamin D, and calcium supplements. Women in particular, he advised, should utilize the advanced Dexa-scan bone density and body composition screening at Sharp Coronado Hospital.

At a second meeting, results are shared of initial testing. And, together with the patient “we come up with a wellness plan,” Yassini explained. “It will contain a lifestyle component, a nutritional component and a medical component.”

“If part of the plan is weight loss, we create a manageable program and I monitor it,” he said. “Same with exercise. Part of the program might be hormone modification. We need a rational approach to hormones. No one should be replacing hormones at levels higher than what your body would naturally produce. We recommend only natural bio-identical hormones and dose them just enough to restore a body to normal optimal levels.”

Vitamins are analyzed. “Sometimes I’ll have a patient bring me all a whole bag of vitamins, and we get rid of much of what they are taking. Some are duplicative or too potent.”

Yassini also said there’s a lot going on in our gut. “Our intestinal track is a huge depository of immune cells that are the barrier between the outside and inside world.”

And when the intestinal tract is subjected to highly processed foods typical in the American diet, Yassini said, “It revs up our intestinal lining. It’s like having a car parked in the garage and putting your foot on the gas.”

Inflammation can result, and inflammation is at the root of a number of medical maladies. “My wife is a dentist and there’s been direct links to heart disease that stem from tooth decay,” he noted. “And hot off the presses… Alzheimer’s disease is now believed to be an inflammatory disease and consuming an anti-inflammatory Mediterranean diet significantly reduces your risk of developing Alzheimer’s disease.”

Anti-aging addresses the whole person, Yassini noted, including spiritual, emotional and physical components. “That’s why I like to embrace the concepts of integrative medicine and holistic medicine.”

Looking good is an important component of anti-aging, as our outside appearance is a reflection of what’s going on inside our bodies. “It’s amazing how much better a person’s skin will look if they begin taking fish oil caplets,” Yassini said.

Sometimes, small changes are all that is needed to effect big changes. “The benefits of small changes often motivate people to continue,” said Yassini, who said it might be as simple as switching from coffee to green tea, learning to meditate, eating a handful of mixed nuts as a daily snack, or drinking one glass of red wine daily.

Yassini noted that an anti-aging program can’t be handled in the medical world’s standard 15-minute office visit. His clients begin with the executive-level physical that usually requires three hours, utilizing advanced diagnostics to determine risks and intervention, using evidence-based therapies to reduce risk for developing disease.

Then, the initial doctor visit laying out a lifestyle plan is 45 minutes; follow-up visits are 30 minutes or longer as necessary.

“Many of us just assume loss of life quality naturally goes along with aging,” Yassini said. “But symptoms of aging, such as loss of muscle mass, energy, libido, or memory, can actually be slowed or reversed by restoring the natural biochemical balance at the cellular level.”

Also among his arsenal of treatment tools are stress management, mind-body techniques, herbs, supplements and other integrative therapies he recommends that are often beyond the scope of Western medicine’s traditional drugs.

Looking toward the future, Yassini shared a few goals. “I’d like to become more active with our schools and teach our kids about healthy lifestyle choices.”

And ultimately, he’d like to create a nonprofit integrative wellness center in Coronado, “similar to what Dr. Andrew Weil does in Arizona,” he said. “Its mission would be to make our community well. It would be available to people who don’t have insurance and therefore access to health care.”